The Kākā by Bernard Hickey
The Kākā by Bernard Hickey
In conversation with Dr Sarb Johal on the psychology of living through our Covid-19 era
3
0:00
-32:27

In conversation with Dr Sarb Johal on the psychology of living through our Covid-19 era

Wellington-based clinical psychologist Dr Sarb Johal works with organisations on managing their way through Covid-19. I asked what he'd learned through Aotearoa-NZ's response.
3

TLDL: I’m fascinated by how the psychology of humans as individuals and in groups shapes our political economy, and in particular how our brain chemistry, our feelings, our social instincts and gut feelings affect the way we work, spend, invest, play, vote and react to this increasingly global and virtual world we live in.

I was trained in the classical economics mold of believing consumers, workers, capitalists and voters were all discrete individuals with access to perfect information and making rational decisions. Mathematical and econometric models were the tools we used to understand what was happening in the political economy.

The longer I’ve covered economics, business and politics, the more I’ve questioned how useful and relevant these models and this framing is for understanding how the real world works. I’m increasingly interested in the field of behavourial economics and the learnings of the likes of Daniel Kahneman, Amos Tversky and Richard Thaler. The used what they learned about the psychology of judgement and decision-making to explain all sorts of economic phenomena. In particular, they showed we often use various short-cuts and biases or ‘heuristics’ to make apparently irrational decisions.

Their work helped create the policy-making practice known as ‘Nudge’ theory. Thaler wrote the book ‘Nudge: Improving Decisions about Health, Wealth, and Happiness,’ which has become influential for some policy makers. The British Government even had a special ‘Nudge unit’ in Government to advise how to use these lessons about behaviour to design various incentives, positive reinforcement and indirect suggestions to gently push savers, consumers, workers, owners and citizens in a direction they might not take automatically. Our Department Of Prime Minister and Cabinet lists ‘Behavioural Insights’ as part of the Government’s policy toolkits.

How it all fits with Covid-19

I also see the Covid-19 crisis as a short of giant test or experiment in how different societies, economies, governments and companies react to the same massive global shock simultaneously. We’re now seeing the results in real time.

So I invited Wellington-based clinical psychologist Dr Sarb Johal in for an interview in the Parliamentary Press Gallery’s studio in Parliament. I wanted to ask about the behavourial insights being used and trialed during Covid-19, both here and overseas.

Dr Sarb Johal (right) and myself outside Parliament. Photo: The Kākā

Last week I did an episode of my weekly podcast ‘When the Facts Change’ on how New Zealand could ‘nudge’ our way to herd immunity.


We talked about how those mental shortcuts or heuristics affected our own reactions during Covid-19, and how our worlds might change as we learn to exist with Covid-19 in the long run. It was a fascinating discussion and I’m grateful Sarb gave up his time for the chat. The bolding in the transcript is mine.

Here’s the conversation transcript:

Bernard Hickey  00:48

Kia ora and welcome to another podcast on The Kākā. I'm Bernard Hickey, here in the parliamentary press gallery, with Dr. Sarb Johal, who is a clinical psychologist based here in Wellington.  I wanted to have a chat with you because I'm fascinated with humans, I love finding out what are the reasons we do things individually and collectively as my background is in training as an economist. And increasingly I'm less enamoured of the macro economics and the micro economics of the classical mathematics-driven style. I'm much more interested in the behavioral economics, the sort of understanding of how humans operate and what you can do with policy or just understanding to make sure that you get the best possible outcome. And because humans aren't always rational, and particularly when they're in groups, they can do funny things. So with COVID, it's an extraordinary event and we've all been put in places that we never expected we would be. Things have happened and not happened. And I would love to understand how the study of psychology and particularly mass psychology, is changing the way we respond to COVID. And I'm particularly interested in vaccination programs. What can you tell us about what's been learned around the world about what works, what doesn't work? And how New Zealand could respond.

Sarb Johal  02:49

Let me go back to 2005-2006, which is when I first started working in emergency management, when we were thinking about H5N1 as the pandemic that we were next in line for. We did a ton of work there around how to understand and to support communities. But I think you're right in that it was quite individually focused, and individually based. And I think that that's where we were in the world at that time. We were thinking about psychologists as independent decision makers. And I think that again, you've hit upon something around: on what variables do we base our decisions? And I think that you're right, in that there was a kind of assumption that we were walking equations, we would take in various inputs, and we would come to some kind of deliberation. And we would make a cognitive rational decision as to what it is that we should do at that point in time. And maybe some of the planning fell in line with that, saying, ‘Well, okay, if this happens, and this happens, then a person will process this information. And this is the behavior we could expect’.  I think in recent decades, even going back to my own training, I remember being very dissatisfied with what I was being told around how humans behave. And some people use the word irrational, I would not use that word.

I would say that we make decisions based on all kinds of different inputs, not necessarily what we're being told, what we read, what we see. But we have all sorts of internal drivers, including our emotions, including the shortcuts that we take, because we can't process all the information that's coming to us. We have to have ways of summarizing that. And then going on things like gut feel. How does this actually make us feel?  Or, and this is a really important thing, what other people are doing around us? Because when we are in situations of uncertainty, and we don't know what to do, we start to make assumptions where people are looking fairly sure about what they're doing around us. We assume that they know what they're doing. And look, they haven't died yet. So I'm gonna do what they're doing, because that's got a chance of keeping me alive. 

There all kinds of other things as well, in terms of, you know, the importance of a sense of community. We know from all the research that's been done over decades, one of the biggest predictors of what people what gets people through a crisis is social support. If we understand that, then we can start to perhaps understand the appeal of what we know as conspiracy theories. Because I think it's not necessarily the framework or the explanation that people are giving to account for what's going on in the world. It's actually the sense of community. Number one is that I belong here. Because these people seem to be a tight knit group, and they're inviting me to join them. And the second one: it gives predictability.  And that's been one of the most unsettling things I think for people as we go through the pandemic is that suddenly the world as we knew in 2019, feels like a long time ago, where we could say, we've set with a fair degree of certainty. This is what my Monday looks like, this is what my week looks like, this is what my job looks like. All of that got thrown up in the air for many people, to some extent more than others. But what we crave is predictability.

Bernard Hickey  06:24

That must be so hard for people who are supposed to be leading when part of their role is to give people reassurance that the systems are in place, and they've got this under control, and that they have information in plans to communicate to everyone that will help bring them reassurance when actually, the people in charge have the same uncertainties and the same lack of full information for decisions, and somehow have to communicate on the run that:  A:  I don't know what's going. I don't necessarily know what the right thing to do is. But B…I still have got your back. And I'm not about to run out and dive into a bunker.  So that's what I'm curious about is: how people process that uncertainty. And why it is, perhaps, that in New Zealand, we seemed to hold it together better than some others during that really uncertain time?

Sarb Johal  07:30

It's a huge responsibility to lead in times of crisis like this, where there's a huge amount of uncertainty, not just here in New Zealand, but we also try and get that right, but always checking, what are other people doing what other countries doing? What are my relatives doing? What are the conditions that they're in how we shaping up, you know, and that started off really well, here in New Zealand, where we're looking, and we were being really, really successful. More recently, we're looking at vaccination rates and what's going on in other countries. And we're wondering about what's happening here. And there are many different reasons we can get into that a little bit later on. But I think one of the things that you touched upon there, which is really important is the issue of trust. And the issue of actually, we live in a society, we're very fortunate that we live in a society where, although we have some cynicism around certain professions, like politics, or journalism. We actually live in a place where we have, you know, a high degree of integrity. And I think that we're fairly confident when we hear something that it's probably likely to be true, and it's probably likely to be. We may need to dig around, or we may need to interpret and put a filter on that, but generally speaking, we have a high degree of trust in our society.  So I think then the challenge for leaders, politicians, or in organizations, CEOs, or wherever it is that you lead, maybe just in your family is thinking about what the outcome might be, where we can't be certain, although we can aim or we can be aspirational around where it is that we want to be, and the processes that get us there.  And I think that that's something that we have done quite well here, in building processes and trust in those processes, to make sure that we can get to various checkmarks. But then also think about, well, what's going to continue to keep us safe in this world that we find ourselves in, and how do we rely upon each other to keep each other safe as well, rather than just thinking about: well, I'm all right, in a very highly individualistic society.

And I think that that's where there's something very clearly from our bi-cultural nature, and thinking about what is the culture of New Zealand and how is it that we take care of each other and the blend of cultures that we have in the history that we have in New Zealand, I think gives us a slightly different take on that than perhaps other places.

Bernard Hickey  10:05

So now the big challenge in front of us is getting everyone vaccinated. And all around the world, there is a big chunk of the population, some places bigger than others, who are not only ‘vaccine hesitant’, which is a beautiful phrase for something. And then there is the hardcore, you know, the vaccination opponents? How do we cajole, nudge, ensure the ‘vaccine hesitant’, at the very least, are included in the vaccination total?

Sarb Johal  10:44

It's very tricky. Vaccine reluctance, vaccine refusal has been around with us way before the current campaign and the current challenge that we have in front of us. So, to a certain extent, we don't necessarily want to spend too much time and energy in trying to convince people who we probably don't think are going to be convinced.  But there is this middle ground where we're thinking, Well, what is it that they need, and understanding what people need in order to come to their decision, but also hearing the stories of people who perhaps might regret some of the decisions that they have made, because there's a whole series of stories that I'm hearing now from the US and the UK, or people who, for one reason or another, chose not to vaccinate.

Or they wanted to wait to see what the data said about, you know, possible health impacts later on down the line, are now falling ill and saying, actually, 'I wish I'd taken the vaccine when the opportunity was available to me.'  So those stories I think are interesting, and people start perhaps say 'I can see myself in them' in terms of their thought process, or which community they're from, or some of the other things that might match with them.  So that's an important thing to understand is how do we see what's going on other countries and draw lessons for ourselves?

The other thing I think is really important is what are the constraints and what are the practical things that get in people's way, when you're asking them to come forward to take a vaccine? So it may actually be that information-wise they're okay. Or at least as okay that is they’re gonna be, and it gives them confidence enough to come forward and take the vaccine because on balance of risk, they're thinking that that's probably all right.  But we are driven by more than just facts. So when we have perhaps people in our social circles, who talk about how they've got to have the vaccine, and they have stories around how it was actually an OK experience, and that many other people in your social circle are starting to take the vaccine.

One of the things I think that we also need to focus on is what is that experience like, of going to have the vaccine? Does it match what the community needs? Do they want to be in a big center? Or would they rather be somewhere more private, more confidential, where you've got, you know, blacked out opaque glass rather than, you know, people looking in to see them.

So really thinking about, well, what is the user experience, you know, one vaccination center was set up, I read like a Samoan wedding, right, and you had the Aunty at the end to make sure that people leave. And they'll listen to the Aunty, but they may not necessarily necessarily listen to somebody else.  Whereas other people are saying, you know, that's just not how we do things in this particular community, we're not going to show up for a mass event. So you really need to be thinking about, what's the experience, like? And are these people who go through the experience, and what are they going to talk about with their friends and family? Are they going to encourage them? Are they going to say, 'Yeah, no, I wouldn't bother. It was a horrible thing to do. I would wait a little while until they figure out what they're doing.'  So I think focusing on that user experience is something that may help with those people who are okay with getting the vaccine: 'But I don't want it like THAT. I don't want to take it in this particular way. I would rather it be delivered to me in a different way.'

Bernard Hickey  14:18

So maybe not force everyone to do a selfie immediately after the vaccine?

Sarb Johal  14:23

No, not at all. It may be they want to keep it on the down low. I've thought about it myself. When do I tell people about when I have the vaccine? And I've thought, well, maybe it's when I've completed it, because I feel like the job's not done until I've had the second one.  There's all sorts of complex things that people think about. The vaccination process is not just one vaccine. It's making sure that they come back for the second that seems to be really important. And there may be a third we don't know yet. That's right. Yeah.

Bernard Hickey  14:50

So what have we learned from the rest of the world? By necessity or choice we're at the tail end of the pack. Some countries are up to 60-70% and seem to have been successful. Canada, the UK, maybe not so much the United States, but some other countries have very high vaccination rates.  What are the lessons? What are the tips and tricks we've found so far? In terms of what works and what doesn't?

Sarb Johal  15:22

It's really interesting to see and compare what countries have have gone through. If you look at the UK, my understanding through networks that I have -- I used to be a private secretary in the UK Government to the Minister for Minister of State for Health, so I talk quite a lot with people. Once they understood how important it was that the NHS was delivering the vaccine, because again, it's about trust, but also that Public Health England, who had the expertise and operational knowledge around how to deliver vaccines, because that's their job, were bought back into the fold, because I think that they were kind of scapegoated quite a lot for the test and trace failure. So then I think there was all kinds of political conversations around it.  But once they settled on having the right people around the table to deliver the expertise in a way that was acceptable to the population, I think that those factors coalesce such that people started to come forward, plus the driver of people saying: 'I want this to be over. And I am being told that if I have a vaccine, this will be over.' Now: it's looking more complex than that. And that's what we're starting to see around the world, so complex in different ways. One is that people seem to be running into a bit of a barrier around the sort of 50% to 70% mark, where the number of people who are coming forward for vaccines is starting to tail off. And my understanding is that actually we possibly need a bit higher than that in order to get what has been called Community immunity or herd immunity in order to see that as a real, really effective protective barrier by itself.

Bernard Hickey  17:19

Although even that is starting to fade away as a clear idea, because it seems people who are vaccinated, can get the infection and spread it but not necessarily be so sick they have to go to hospital. Which means that people who are vaccinated who come into the country, for example, they may have a juicy vaccine tick on their passport. And we think: 'Wow. That's great. They're not going to spread it to us' And then they spread it to us, or we spread it to them.

Sarb Johal  17:53

Absolutely. So the complexities of the type of the variant that we're talking about, but also, I was reading some stuff from Israel today. And they were saying that actually the Pfizer vaccine immunity level protection seems to drop off after about six months.  The fundamental point here is that behavior still remains the fundamental thing that we need to be thinking about in order to understand what it's going to look like to live alongside the virus for the next three to five years.  Coming forward to get a vaccination is a really important part of that behavioral toolset, but to tell people and to raise hopes that the pandemic will be over if everybody gets vaccinated in an individual country sense, I think misses the point.  I think this is actually just another layer of our behavioral toolset and all the other tools that we have. But actually, to keep each other safe. We need to be thinking in a global context, but also what else do we need to be doing to keep ourselves and each other safe?

Bernard Hickey  18:58

A bunch of people got high vaccination rates and then cast off the shackles by saying 'no need to wear masks. We can all go dancing together. And then a few weeks later, 'you should all be wearing masks and keep the social distancing. You’re right. There's no: 'Are we there yet? Bang, we're there. We can all relax.' It's not going to be that sort of thing, unfortunately.  Tell me about what we've learned about how humans have dealt with lockdowns, the whole COVID shock and fear and disruption in terms of you know, things like anxiety, mental health problems, burnouts? What are we learning so far?

Sarb Johal  19:52

In the early days in New Zealand experience, I think that the alert levels structure that was announced was incredibly containing for people. In the short term, it gave them predictability of what it is that they could do, what it is that they shouldn't do, what it is that they were being asked to do in order to take care of themselves and other people around them. And I think that that acted as a really good container for the anxiety that was being caused by the situation that we found ourselves in. As we've progressed forward in time, we've been relatively lucky here and that we haven't had too many major lock downs, and some of them have been in Auckland, and we had a recent not a lockdown, but an increase in alert level in Wellington too. But even there, we've seen an increase in anxiety for people, which has been uncovered by research studies of, as they went through those lock downs, but also uncertainty about the future that's being shown in an increased willingness to keep the borders pretty tight. Until we get to a position where we can be more confident that we're going to be protected if the borders are being opened.

Bernard Hickey  21:07

It's interesting to see the surveys picking up that large chunks of the public are actually a lot more conservative than people in government and in business about when to open up or how quickly or how much to open up. And there is a bit of a feedback loop in there that the government is seeing that and understanding that they can push back a bit or at least hold the line a bit harder against those people who are saying: 'We've had enough and just open up.'

Sarb Johal  21:38

It's interesting to understand a bit about where does that come from the ‘we've had enough. Let's just open up.’ I think one of the things that we've learnt in the research over the last couple of decades is we have the difference between the primary stressor that we're worried about, and then the secondary stressors that then start to make an impact. 

So in this case, in the pandemic, the primary stressor is the virus itself, the havoc that that could cause and damage and death if that was unrestrained and let rip. The secondary impacts are things like the impact upon the tourism industry, the impact upon the hospitality industry, but also more complex second order secondary impacts, like labor costs going up, because we don't have the pool of labour that we would normally have because the borders are closed, or supply chain issues. Because shipping is now so much more expensive. We have people in rural communities who can't get their fencing done in a way that they could before, because it's become unaffordable because the materials.

Or the construction industry. I was reading an article last week saying if you're insured, you need to check how much you're insured for in terms of reconstruction costs of your house, because those construction costs have gone up appreciably. So these are secondary impacts that we're now starting to get worried about because of the impact of the Coronavirus, not just upon us, but on the global economy. And these are the things that I think are concerning people whose job it is to work in those industries and businesses and the income that they generate for New Zealand, 

Though to a very large extent, I agree that without health, we have no economy, we're now in the position where we're thinking in six months time, when we have pretty much given the opportunity for everybody to come forward and have their two doses of vaccine, and still keeping an eye forward in terms of what does that look like for long term immunity, what is our process to re-engage with the rest of the world knowing and seeing what it is that the rest of the world is doing too. That's where the uncertainty has many different levels of it that people are trying to process. And we know that we can't process all that much all at the same time. So that's when we start to look to leadership and other social groups around us. And what are they saying? What do they know that I don't know? And is it easier for me to let them do the thinking for me, rather than having to try and figure this out myself?

Bernard Hickey  24:17

You do a bit of consulting with various organisations about how to understand and come up with policies or practices to deal with the sort of anxieties and stresses that workers and citizens having? What could a large organisation, head of HR or CEO, what should they understand and know before they start ordering people to come back into work or to stay away at home or those sorts of things?

Sarb Johal  24:53

It's a complex task for organisations trying to figure out and navigate their way forwards. Rather than thinking about outcomes, I'd be thinking about processes, and how one process is not going to fit everyone. So really thinking about rather than people working from home or not working from home, I think we've seen more and more conversation about what hybrid models are going to work for people. So maybe, you know, three-two split, you know, there are home three days of the week, or one or two days, they'll be they come into the office, and what is that going to look like? And who does that privilege in terms of who gets to be in the office? Who gets the attention of the boss and all that stuff needs to be thought about?

It's complex stuff that needs to be thought about? But in terms of things like, what is the wellbeing of your staff going to look like going forward in the future? And are we talking about people who are really stressed out or depressed?  Or are we talking about people finding that they've got a renewed sense of purpose, they see it as an opportunity, or for the majority of people who at any one time are probably in a state of languishing. So this is this idea of a feeling of stagnation or emptiness or not knowing what's going to happen next, but not feeling particularly motivated to meet that challenge. It all feels a bit too much.

And so I think that the process that organisations are probably going to be starting to go through now, if they're wise, is they will start to think about in this new world, in this new environment, which is not going to look like 2019. And it's not going to look like the early days of the pandemic. What's our purpose? What are we here for? And then how do we talk about that with our employees? And everybody who's in our organisation around: 'Does that match?'

There's this been talk about this great resignation, this idea that people are looking at their roles, looking at their jobs and saying, 'you know what, I've got an opportunity here, that I'm going to change what I'm doing. We've seen this before, in New Zealand. We've seen this after the Canterbury earthquakes, people who were tasked to help others, whilst they were going through the same thing thing themselves, they started to make decisions around, actually, 'I've suddenly figured out over the last months and years, that stuff isn't that important to me, material goods aren't that important to me, what's important to me, is relationships. But I also don't want to hear talk about the earthquake so much anymore, because I'm kind of sick of it'.  So they started to manage themselves out into roles, either within the same organisation or in different organisations where they could manage their exposure to things that are really stressful.

And I think that that's what we're seeing is that people are saying: 'What are my goals, one of my dreams. That was a close scare, I'm going to start chasing them a bit more than perhaps I did.' But people at the same time are saying: 'That was really stressful, and I really need that in my life anymore. I want to do something else that isn't anywhere near as stressful as that.'

Bernard Hickey  28:01

'It's one of those milestones, those events that in decades to come, we'll all look back on is the big thing in the same way that people in the 50s and 60s, look back on the Second World War. Or earlier than that they looked back on the great depression or the First World War. Have you thought about how this might change society or the way we do things? It's probably early too early to say, but I'm guessing you're a student of history and how people have reacted to these sorts of shocks in the ideas.

Sarb Johal  28:37

I've heard talk about, you know, the roaring 20s, you know, and will we see this kind of like big boom, and you know, how will that impact upon prosperity in nations. I think one of the things that we forget or can can look past is that roaring 20s was not great for every one. It was very much a select few who managed to gain from that. And then what happens to everybody else? 

I think one of the things that we can look upon with pride is how we came together as that team, 5 million, 6 million if you include those people who perhaps were offshore, and we're thinking about, well, how am I going to get back? So I think that there was some discourse and debate around that. But then that starts to fall away.

This sense of collectivism that gets you through the initial impacts, we then start to think about, well, what's my path forward? And what about my tribe or my community? And we see this again in other disasters: we see this kind of fracturing of networks, where some people kind of benefit through particular outcomes and other people don't: they lose. 

What we know about disasters and crisis is that they magnify inequalities that existed before the disaster. We have really big work to do in New Zealand around some inequalities that affect us as a nation, and particularly where the burden of those inequalities lie.  So I think that we need to be forward looking and thinking about, well, 'what are the economic impacts or whatever is going to come next?' And how can we monitor those in a really close way so that we can act early? And how can we also cooperate as international regions, or as rules-based systems, such that we can make sure that we spread the wealth that is generated, but also ease the burden and pain, as they become clear as we emerge out of whatever comes next, in the next stage of the pandemic.

Bernard Hickey  30:51

Could you give us any tips or tricks you've learned through this process in terms of keeping yourself and organisations safe? Because I've learned, for example, to turn off my email and not spend all my time on zoom calls. That whole zoom fatigue and burnout thing is a real thing. But also any anything you'd say to people that that might help or, or, and enter organisations as well.

Sarb Johal  31:22

One of the perverse things about the pandemic is that we know that social support is one of the things that get us through disasters, but we were told not to see each other, and not to be close to each other. And so one of the things that we did is that we became really dependent upon tools like the internet, like screens, like our devices in our pockets. And that might have slipped into habits that aren't that great for us.  So I think one of the big things that I've learned myself, is that actually starting to put some windows around when I can, and when I can't do that seems to be really helpful for me.

But I think it's the fundamental planks of things like diet, exercise, and also sleep. Sleep is vastly underestimated in terms of thinking about our wellbeing. We borrow against sleep all the time. We go: 'I'll sleep at the weekend, but that doesn't happen. And even if you do, it doesn't really refresh you. So really thinking about structure.

One of the things I talked about constantly throughout the pandemic is the importance between the two poles, the two things that we need when we go through difficulties in our lives. One is structure and routine, that helps you know, with that alert level system in terms of creating that container, you have some predictability in our lives, but also empathy, not only for other people what they may be going through, but also for ourselves. 

This is tricky, this is hard. We're living, we're leading, we're parenting, we're trying to get stuff done in the middle of a global pandemic. And that continues as we go through, you know, maybe I remember going through talking with some agencies when we were going through the years three and four of the Canterbury earthquake. And people would say, well, that's not earthquake related. So why should we get involved in that?

The conversation was, everything is now earthquake related, it makes no sense to differentiate, what's earthquake related or not? And similarly, I think as we go through the pandemic, everything will route back to how it is that we deal with or cope with the pandemic.  So any opportunity that we have in order to figure out where are we and how are we with our well being. What are the routines? And how is it that we want to structure our own lives as we progress forward over the next three to five years, or however long it takes for us to really get to grips with living alongside this virus in our lives?

Bernard Hickey  33:48

That's very useful. Actually. What I've found particularly on the sleep side is 'Nana naps.' I love a good Nana nap. Dr. Sarb Johal, who is a clinical psychologist and independent clinical psychologist here in Wellington, a consultant commentator, Speaker, thank you very much for coming into the studio here. And I've really enjoyed the chat. I hope that all of those people listening through this podcast on the Kākā, have enjoyed it.

Ends

3 Comments